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University of Iowa News Release


Aug. 13, 2007

Grant Provides $1.9 Million to Improve Nursing Home Care

Researchers in the University of Iowa College of Nursing have received $1.9 million in funding from the National Institute of Nursing Research to promote evidence-based practice in long-term care settings in order to improve care and patient outcomes.

Janet Specht, Ph.D., professor, is principle investigator and Paula Mobily, Ph.D., associate professor, is co-principal investigator for the project.

Poor-quality nursing home care and resulting poor resident outcomes are of increasing concern, particularly for elders with urinary incontinence and pain, according to Specht and Mobily. "Despite the availability of evidence-based practice protocols that could dramatically improve care and outcomes, the use of these protocols in nursing homes is sparse," Specht said.

The team will evaluate outcomes for nursing homes, elderly residents and new ways to help registered nurses and certified nurse aides use the most current knowledge to care for elders with pain and urinary incontinence.

The UI study, "Improving Continence and Pain Control in Long Term Care: The M-TRAIN Intervention," builds on the pilot work sponsored by the John A. Hartford Center of Geriatric Nursing Excellence conducted in partnership with nursing homes. It proposes a systematic trial of the Multi-Level Translation Research Application in Nursing Homes (M-TRAIN) intervention.

M-TRAIN combines models of translation research and empowerment research. The evidence-based practice (EBP) component targets dissemination and implementation of practice changes, while the staff empowerment component increases a staff's sense of job ownership and personal satisfaction, which may decrease turnover. It is hoped the two approaches will be mutually reinforcing and will result in better resident outcomes than either alone.

The study is innovative because M-TRAIN addresses nursing homes and staff variables that are barriers to practice changes, including training and supporting staff teams for EBP implementation and using an "insider" nurse consultant to assist the teams with implementation.

"This research is significant because of the urgent need in nursing homes to improve outcomes for elderly residents with incontinence and pain, to retain staff, and the potential the EBP empowerment intervention has to do both," Mobily said.

Collaborators include Keela Herr, Ph.D., professor and chair of the Adult and Gerontology Area of Study in the UI College of Nursing, Gerald Jogerst, M.D., professor of family medicine in the UI Roy J. and Lucille A. Carver College of Medicine; Sara Sanders, Ph.D., assistant professor of social work in the UI College of Liberal Arts and Sciences; David Reed, statistician in the UI College of Nursing; and Sheila Horras, an expert long-term care nurse. Consultants for the project include Marita Titler, Ph.D, director of the UI Gerontological Nursing Interventions Research Center Research and Dissemination Core; Meridean Maas, Ph.D., professor emerita and co-director of the Hartford Center at the UI College of Nursing; and Nancy Watson, associate professor and director of the Center for Clinical Research on Aging at the University of Rochester in Rochester, N.Y.

STORY SOURCE: University of Iowa College of Nursing, 101 Nursing Building, Iowa City, Iowa 52242

MEDIA CONTACT: Michele Francis, 319-335-8960,